Individual provider Active NPI

Benjamin James Newberry, PA C

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1376944777
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
376 E Apple Ave
Muskegon, MI 49442-3466
Phone
(231) 734-1335
NPI assigned
Sep 5, 2014
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

376 E Apple Ave
Muskegon, MI 49442-3466

Mailing address

2700 Baker St FL 3
Muskegon, MI 49444-2157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141015001961 MI Practitioner - Physician Assistant 2860613841 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MuskegonGroup PAC ID 2264325448, 32 clinicians

Practice addresses (Care Compare)

376 E Apple Ave
Muskegon, MI 49442-3466
Phone (231) 724-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Newaygo County General Hospital Association CurrentSince Oct 20, 2014 Accepting new patients
Hackley Life Counseling CurrentSince Jan 1, 2019 Accepting new patients
Hackley Community Care Center Inc CurrentSince Feb 18, 2020 Accepting new patients
Hackley Community Care Center, Inc CurrentSince Feb 18, 2020 Accepting new patients
County of Muskegon CurrentSince Mar 16, 2021 Accepting new patients
Hackley Community Care Center Inc Past Accepting new patients

Locations

204 W Main St
Fremont, MI 49412
Phone (231) 924-1122

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

125 E Southern Ave
Muskegon, MI 49442
Phone (231) 724-3699

1675 Leahy St
Ste 103
Muskegon, MI 49442
Phone (231) 728-4915

376 E Apple Ave
Muskegon, MI 49442
Phone (231) 724-3699

2700 Baker St
Fl 3
Muskegon Heights, MI 49444
Phone (231) 733-6607

1877 N Getty St
North Muskegon, MI 49445
Phone (231) 728-5052

640 Seminole Rd
Norton Shores, MI 49441
Phone (231) 332-3827

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1376944777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 E APPLE AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494423466",
            "telephone_number": "231-734-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "BENJAMIN",
        "middle_name": "JAMES",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-05",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.